Mindy J. Kim-Miller, MD, PhD
There is growing evidence for a link between cardiovascular (heart) disease and Alzheimer’s disease (AD). Both diseases share common risk factors including hypertension (high blood pressure), cholesterol, diabetes, obesity, smoking, and ApoE4 (a gene which has been associated with atherosclerosis, AD, and possibly vascular dementia). The intriguing part of these findings is that it may be possible to prevent cognitive decline and AD by targeting these cardiovascular risk factors.
It is well known that hypertension is a direct risk factor for stroke and vascular dementia. However recent studies have suggested that hypertension during midlife is also a risk factor for the development of AD; those with hypertension are twice as likely to develop AD. Other studies suggest that high systolic pressure with low diastolic pressure in older adults is associated with an increased risk of developing of AD. In the proposed mechanism, atherosclerosis due to long-standing hypertension leads to poor blood flow to the brain, which may contribute to the development of dementia. Low diastolic blood pressure in late-life may further worsen blood flow to the brain. Peripheral arterial disease (narrowed arteries leading to poor circulation in the arms or legs) has also been associated with a two-fold increase in the risk for AD, further supporting the theory that inadequate blood circulation may contribute to AD. Other modifiable risk factors include cholesterol level, obesity, and smoking. High cholesterol levels (≥ 6.5 mmol/L or 250 mg/dL) during midlife have been associated with a two- to three-fold increase in the risk for AD. Diabetes, obesity, and smoking also roughly double the risk for dementia.
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